Aim: This study was carried out to evaluate the effects of granulocyte colony stimulating factor (G-CSF) therapy on candidial sepsis in neutropenic neonates.

Material and Method: The prospective, double-blind, randomized and placebo controlled trial was performed on 31 neutropenic neonates with candidial sepsis administered G-CSF in 16 infants (group I) or placebo in 15 infants (group II). G-CSF therapy (5 µ g/kg/day, for 5 days) or placebo was administered as soon as the initial sepsis findings appeared. Liposomal-amphotericin B (L-AMB) treatment was started when candida determined in blood culture. Score for neonatal acute physiology (SNAP) was calculated at the beginning of the study. Töllner’s sepsis score, complete blood counts, absolute neutrophil count (ANC), lymphocyte, monocyte and eosinophil counts, immature to total neutrophil ratio (I/T) were performed or calculated on the 0 to to 5, 7, 10, 14, 21th days.

Results: Mean gestational mean birth weights, mean postnatal ages at the diagnosis of intection age of group I and II were similar. The prematurity rate was 94% in group I and 93% in group II. At the beginning of the study; Töllner’s sepsis score, SNAP, ANC and APR levels were similar in both groups. However, increase in ANC, decrease of sepsis score and APR were significantly higher in group I than group II. The periods of clinical improvement, the duration of L-AMB therapy and hospitalization for infection significantly shorter and the cumulative dose of L-AMB was significantly lower in group I than group II. Although the mortality rate was lower in group I than group II, albeit difference was not significant. No adverse effects of G-CSF were noted, but hipokalemia related to L-AMB was observed only in one patient.

Conclusion: It was concluded that the administration of G-CSF plus to antifungal agents in neutropenic neonates with candidial sepsis is safe and reliable.